Office of Public and Intergovernmental Affairs
Remarks by Secretary Robert A. McDonald
American Legion Convention
Remarks by Secretary Robert A. McDonald American Legion Convention Cincinnati Ohio August 31, 2016
August 31, 2016
Dale, thanks for your leadership of the American Legion and for that kind introduction. Let me also recognize Ralph Bozella and Verna Jones.
Other members of the Legion’s Executive Office, fellow Veterans, colleagues, distinguished guests, ladies and gentlemen—thank you for that warm welcome.
Over two years ago now, I had my confirmation hearing with the Senate Committee on Veterans Affairs. I was asked then, “Why do you want to be Secretary of Veterans Affairs?” I told them: There’s no higher calling. There’s no more noble mission.
When President Obama asked, I didn’t hesitate. It’s an opportunity to make a difference in the lives of my fellow Veterans.
At that hearing, I pledged to work to transform VA—improving access to the high-quality care and benefits that Veterans earned and deserve. And I pledged to work with Congress, with our Veteran Service Organizations, and with other stakeholders.
After confirmation, my first stop was Phoenix—and then Las Vegas, Memphis, Reno, Palo Alto, and Charlotte. Across 23 cities, I consulted thousands of Veterans, VA employees, and VSO leaders—the American Legion one of the very first. We talked about how we could shape our MyVA transformation strategy, so VA would best serve Veterans.
Here’s the point—MyVA isn’t my strategy, it’s yours. It’s not about me, it’s about all of you. It reflects your ideals, your insights, and your innovations.
You’ve heard many times that VA is broken. I disagree. We have challenges, yes. But VA can be transformed. Transformation is well underway—and we’re already seeing results.
Changing VA means changing leadership. Fourteen of our top 17 executives are new since I became Secretary. These are world-class, enthusiastic business leaders and healthcare professionals. Eight of them are Veterans themselves.
And since March of 2015, our new MyVA Advisory Committee has been hard at work. Committee members have brought extensive experience in customer service and organizational change. They’re leaders in business, medicine, government, and in Veteran advocacy.
Among them are Veterans like Major General Joe Robles. After 30 years in the Army, Joe was President and CEO for USAA. Dr. Richard Carmona is a Special Forces Vietnam Veteran and was the 17th Surgeon General of the United States. Navy Veteran Dr. Connie Mariano was the first military woman to serve as White House Physician to the President, the first woman Director of the White House Medical Unit, and the first Filipino American in US History to become a Navy Rear Admiral.
These are innovative, resourceful, respected leaders who are advising us on transformation. They know business. They know customer service. And, they know Veterans.
It’s important you know we’re collaborating with world-class institutions like Johnson & Johnson, USAA, Starbucks, NASA, Kaiser Permanente, Hospital Corporation of America, Virginia Mason, Marriott and Ritz-Carlton, among others.
And it’s important you know we’re partnered with respected organizations like the YMCA, the Elks, the PenFed Foundation, LinkedIn, Coursera, Google, Walgreens, academic institutions, other Federal agencies, and many more.
Over the last two years, we’ve partnered with local leaders to help build a new national network of 76 Community Veterans Engagement Boards—CVEBs.
CVEB partnerships leverage community assets as well as VA assets to help ensure we implement local solutions to meet Veterans’ needs in our communities.
Our goal is 100 CVEBs across the country by year’s end. If there’s no CVEB in your community, let’s help make it happen!
Partnerships are the foundation of our progress in ending Veteran Homelessness—VA working with the Department of Housing and Urban Development, the United States Interagency Council on Homelessness, businesses, criminal justice, mental health, nonprofits, local elected officials, community providers, local VSOs, the faith-based community, and philanthropists, to name a few—close to 4,000 public and private partners.
We launched our 25 Cities Initiative in March, 2014. A few months later, First Lady Michelle Obama announced the Mayors Challenge to End Veterans Homelessness. Over 880 mayors, governors, county and city officials accepted. Those partnerships are why 28 communities and two states have achieved an effective end to Veteran homelessness—and why over 360,000 Veterans and family members have been housed, rehoused, or prevented from falling into homelessness since 2010.
In Los Angeles, the worst city in the country for homelessness, we cut Veteran homelessness by more than 30 percent last year—about four times the rate of decline of previous years.
Veteran homeless nationwide is down by 47 percent since 2010. We’ve cut it in half.
New leadership, innovative collaboration, expanded partnerships—all of that matters.
Now, let me talk about VA healthcare.
You know VA’s the largest integrated health care system in the country. We have a unique lifetime relationship with our nine million patients . . . and a single electronic health record across the entire enterprise. Nobody else offers that.
Our mental health care’s integrated with primary care, with specialty care, and with psycho-social support to minimize barriers and help resolve problems early. Nobody else offers that.
VA healthcare is whole Veteran healthcare—body, mind, and soul, customized to meet Veteran needs. Yoga? Acupuncture? Sports therapy, music therapy, writing and art therapy? We validate and embrace what works to heal Veterans.
And VA care is integrated with non-medical determinants of health and well-being that people often miss. I’m talking about things like education services, career transition support, fiduciary services, pension resources, disability compensation, and many others.
Nobody else offers all of that.
And our Under Secretary of Health Dr. David Shulkin is changing our system to proactive, holistic health care and wellness.
Let me talk about access to VA healthcare. You should know that more Veterans are coming to VA for our care, and waiting less time.
Last year Veterans had nearly four million more appointments than the previous year—almost 57 million were in VA facilities, over 16.8 million were VA care in communities. Last March Veterans set a record for completed appointments—5.3 million inside VA, 730,000 more than March 2014—and VA issued 268,000 authorizations for care in the community—twice as many as March 2014.
In July, 96 percent of appointments were completed within 30 days of Veterans’ preferred date. Eighty-five percent were completed within seven days. And 22 percent were completed the same-day.
You should know that average wait time for primary care is around five days, six days for specialty care, and two days for mental health care. And by December, you can expect same day access in Primary Care and same day access in Mental Health Care.
By the way, VA’s the only healthcare system that publicly reports on wait times as a measure of access.
Ninety percent of Veterans we’ve surveyed are “satisfied or completely satisfied” with the timeliness of their care. We won’t be satisfied until we hit 100 percent.
So we’re making important progress. But you rarely hear that in the media.
You’d never know we lead in many fields of research that benefit all Americans—PTSD, Traumatic Brain Injury, Spinal Cord Injury, prosthetics, genetics.
You’d never know the American Customer Satisfaction Index rated your National Cemetery Administration No. 1 in customer service five times running.
You’d never know J.D. Power rated your mail-order pharmacy best in the country in customer satisfaction six years running.
Once, all you heard about was our backlog—611,000 claims more than 125 days old. So, we added staff, adjusted policies, and designed an automated claims processing system.
Today the backlog is down almost 90 percent. The average time waiting for a completed claim is down 65 percent.
That’s the work of industrious employees and leaders, many of them Veterans—but you never read about that. Listening to some people, we’d never know there’s a decent person working at VA—Veteran or otherwise.
Well, these last two years I’ve met and talked with thousands of VA employees and leaders in over 330 locations—many of them Veterans, like us.
They’re people like Cathy DeNobile, a nurse with our D.C. Home-Based Primary Care Office. Every Thanksgiving and Christmas, Cathy takes a holiday dinner to a Veteran she cares for who served in Iraq—a guard at Abu Ghraib. He’s suffering severe PTSD, and he doesn’t get out of the house much.
Chuck Malden’s an Emergency Room Nurse at the Salisbury, North Carolina, VAMC. One day Chuck was treating a Veteran for blisters, and he literally gave the Veteran the shoes off his feet. Why? Because the Veteran needed better shoes. Because he cared. Because that’s what we’re about.
Our employees are good people. I’m proud of them.
No, they’re not all perfect. But it’s a gross misrepresentation to cherry-pick the worst and hold them up like they represent VA employees, just like it’s a gross misrepresentation to hold up a bad Veteran to represent all of us. It’s a distortion that sells papers, but it’s a distortion that hurts Veterans and the good people caring for them.
Some claim there’s no accountability at VA.
Don't think we hold people accountable? Tell that to the VA employee in Augusta, Georgia, recently convicted of falsifying healthcare records. He’s facing sentencing that could include years in prison and thousands of dollars in fines. All told, we’ve terminated over 3,755 employees in two years.
Some people think everything will be fine if we fire more people, more quickly. But that’s just not true. We can’t fire our way to excellence. Over my 33 years in the private sector, I’ve never encountered an organization where firing people was a measure of leadership.
We won’t punish people based on opinions, recycled and embellished media accounts, or external pressure. It’s not in the best interest of the Veterans we serve.
Excellence is what we’re after. So the right dialogue is about forward-looking leadership, and sustainable accountability. Sustainable accountability gives you positive outcomes—that’s leaders and supervisors providing routine feedback, just like in well-led, well-trained military outfits. It’s recognizing what’s going well, coaching and re-training when improvement’s necessary, ensuring employees understand how daily work supports our mission, values, and strategy. It’s training leaders to lead and employees to exceed expectations, every day. And, it’s taking corrective action when it’s warranted and supported by evidence.
These are pretty simple concepts for Veterans. These same principles built the greatest fighting force in history.
We’re serious about the work we’re doing for you, and we have the opportunity to look back at 2016 as the year we turned the corner for Veterans.
But there are some things we can’t do without the help of Congress.
The Senate Appropriations Committee approved a budget nearly equal to the President’s request—but the House proposed a $1.5 billion reduction. That will hurt Veterans and impede critical initiatives to transform VA into the high-performing organization you deserve.
You should know there are more than 100 legislative proposals for Veterans in the President’s 2017 Budget—many vital to maintaining our ability to purchase non-VA care.
Only Congress can modernize and clarify our purchased care authorities to streamline access to Community Care programs in years ahead. We submitted our plan last October, but we need congressional action to execute it.
Only Congress can enact legislation so we can better compete with the private sector, get the best medical professionals to choose to serve at VA.
And perhaps most importantly, only Congress can modernize the archaic appeals process. Last year, the Board was adjudicating an appeal that originated 25 years ago. Under current law, with no significant change in resources, the number of Veterans awaiting a decision will soar by 179 percent by 2027—from 500,000 to nearly 1.3 million.
So, with the help of the Legion and other Veterans Service Organizations, the National Association of State Directors of Veterans Affairs, and the National Association of County Veterans Service Officers, we shaped a simplified, streamlined, and fair appeals plan.
It’s your plan.
Your commander knows this needs to get done. Just a few days ago, he sent out a Call to Action on this very subject—thank you, Dale, for joining us in urging Congress to pass the law.
In five years, we could have appeals resolved within one year of filing. The legislation costs nothing, and it will be more efficient and less costly over time.
The alternative? More resources dedicated to a broken system. Veterans waiting 10 years for a final decision on your appeal.
It’s unacceptable to me. I know it’s unacceptable to you. Please join Dale and all of us at VA in getting Congress to act in order to better serve Veterans. Call your members of Congress, visit their offices while they are home campaigning, write them a letter—tell them to act on our proposed legislation and get some good things done for Veterans.
All these proposals require congressional action, and you can help us get them done.
Ninety-five years ago, VSOs helped bring the Veterans Bureau into existence. Nine years later, you helped create the Veterans Administration. You helped get us the GI Bill, the Montgomery GI Bill and the post-9/11 GI Bill. You’re why President Reagan made VA a Department, giving us “a seat at the table of our national affairs.”
And you’re the ones who can keep Veterans in control of how, when, and where they wish to be served. And that’s what MyVA is about.
You’re hearing lots more recommendations about VA’s future. Some have argued VA can best serve Veterans by shutting down VA healthcare altogether. I suspect that proposal serves some parties somewhere pretty well. But it’s not transformational. It’s more along the lines of dereliction of duty.
It doesn’t serve Veterans well, and it doesn’t sit well with me. So make sure there’s substance to those discussions—that they’re about Veterans’ interests, and not something else. Make sure they’re anchored to the service and sacrifice—the sense of duty and honor—that Veterans represent, and only Veterans understand.
It’s your VA. It always has been.
God bless you and your families. God bless Veterans. And God bless the United States of America.